Superficial Granulomatous Pyoderma of the Face: A Case Report and Review of the Literature

Introduction: Superficial granulomatous pyoderma (SGP) is a rare variant of pyoderma gangrenosum (PG) and differs from classic PG in its indolent clinical course, lack of associated underlying disease, the finding of a granulomatous infiltrate on histology, and better prognosis with less-aggressive therapies. Methods: We report on a case of SGP involving the face following local reexcision of a biopsy scar. Results: The patient developed an indolent ulceration following an excision of an unfavorable scar on her face. Discussion: Superficial granulomatous pyoderma is usually responsive to conservative treatment with antibacterial or local anti-inflammatory agents. Facial involvement with SGP is particularly rare and tends to be more refractory to conservative management. Superficial granulomatous pyoderma involving the face appears to respond better to intensive treatment with systemic corticosteroids or immunosuppressants. To prevent poor cosmetic and functional outcomes in patients with nonhealing lesions, it is important for surgeons to recognize the clinical and histopathologic presentation of SGP and consider initiating a more aggressive management approach for SGP involving the face.